曲安奈德联合七叶洋地黄双苷滴眼液治疗渗出型老年性黄斑变性的临床研究

目的探讨曲安奈德注射液联合七叶洋地黄双苷滴眼液治疗渗出型老年性黄斑变性的临床疗效。方法选取2016年3月—2017年3月在湖南省军区机关医院进行治疗的渗出型老年性黄斑变性患者86例为研究对象,根据接受治疗的先后顺序分为对照组和治疗组,每组各43例。对照组在眼结膜囊内滴入七叶洋地黄双苷滴眼液,1滴/次,3次/d。治疗组在对照组基础上给予曲安奈德注射液,0.5 m L缓慢注入玻璃腔内,1次/周。两组患均连续治疗4周。观察两组的临床疗效,比较两组的视力、眼底、临床症状评分、视网膜中央动脉血流、超氧化物歧化酶(SOD)和丙二醛(MDA)的情况。结果治疗后,对照组和治疗组的总有效率分别为74.42%、90.70%,两组比较差异有统计学意义(P0.05)。治疗后,两组视力明显上升,而眼底出血面积、眼底渗出面积、眼底玻璃膜疣面积、黄斑部视网膜厚度均明显下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组纳呆、倦怠乏力、胸闷、视物模糊评分明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组视网膜中央动脉收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)明显升高,而血管阻力指数(RI)明显下降,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组SOD水平显著升高,而MDA水平显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论曲安奈德注射液联合七叶洋地黄双苷滴眼液治疗渗出型老年性黄斑变性具有较好的临床疗效,可明显改善患者临床症状,提高视力,减少眼底出血和渗出面积,改善网膜中央动脉血流、SOD和MDA,具有一定的临床推广应用价值。

Clinical observation of triamcinolone combined with Esculin and Digitalisglycosides Eye Drops in treatment of exudative age-related macular degeneration

Objective To investigate the clinical efficacy of Triamcinolone Acetonide Injection combined with Esculin and Digitalisglycosides Eye Drops in treatment of exudative age-related macular degeneration. Methods Patients (86 cases) with cerebral infarction in Hunan Military Area Command Hospital from March 2016 to March 2017 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were dropped into the conjunctival sac with Esculin and Digitalisglycosides Eye Drops, 1 drop/time, three times daily. Patients in the treatment group were given Triamcinolone Acetonide Injection on the basis of the control group, 0.5 mL injected into the glass cavity slowly, once weekly. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and vision, fundus, clinical symptom score, central retinal artery blood flow, SOD, and MDA level in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 74.42% and 90.70%, respectively, and there was difference between two groups (P<0.05). After treatment, the vision in two groups were significantly increased, but the area of fundus hemorrhage, fundus effusion, fundus film, and the thickness of macular retina in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the scores of anorexia, fatigue, chest tightness, and blurred vision in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, PSV and EDV in two groups were significantly increased, but the RI in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of SOD in two groups were significantly increased, but the levels of MDA in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Triamcinolone Acetonide Injection combined with Esculin and Digitalisglycosides Eye Drops has clinical curative effect in treatment of exudative age-related macular degeneration, can significantly improve clinical symptom and visual acuity, reduce fundus hemorrhage and effusion area, improve central retinal artery blood flow, SOD and MDA, which has a certain clinical application value.